Closed Psychiatric Unit Delays Care

Lack of beds affects mental health patients.

Inova Alexandria Hospital’s psychiatric unit has been closed for only a month and already issues over the availability of beds at Mt. Vernon Hospital have arisen.

“Since the psychiatric unit in Alexandria closed, we have made 11 referrals,” said Dr. Michael Gilmore, executive director of the department of mental health, mental retardation and substance abuse in Alexandria. “In two cases, patients remained in the emergency room far longer than we would like to see and in three cases, beds were simply not available at Mt. Vernon Hospital. Two of these patients had to be admitted at Prince William Hospital and another was admitted in Arlington.

“We knew there were going to be issues when we lost the 19 beds at Alexandria Hospital but, in a sense, we are now experiencing the same kinds of problems that the rest of the state has been experiencing for some time. It’s truly a regional problem and we need to address it as such,” Gilmore said.

In one case, a patient remained in the emergency room at Alexandria Hospital for 24 hours and, in another instance, a patient waited there for seven hours. Normally, when a patient is detained prior to admission to a psychiatric facility, the process takes about four hours. This is the time allowed for police to assist in a detention that culminates in admission.

“The police have been terrific about staying with our workers throughout the process, even though, technically, they don’t have to,” Gilmore said. “They are clearly concerned about the safety of everyone involved, as are we, so we are thrilled to have them with us. Clearly, there are issues to discuss with Inova and everyone else involved,” he said.

INOVA CLOSED THE UNIT as a cost-cutting measure. Nineteen beds were eliminated and only seven were added at Mt. Vernon. Inova released the following statement about recent problems:

“From time to time, there are psychiatric patients who also have special medical needs that can only be cared for in facilities with significant clinical support systems. In one recent instance, a special needs patient did wait several hours to be transferred to Inova Mt. Vernon Hospital. There were beds available at other facilities in Northern Virginia, but those facilities declined to accept the patient. The patient was cared for at Inova Alexandria Hospital until a bed became available at Inova Mt. Vernon Hospital and the transfer could be completed. In reference to three additional patients who were transferred to non-Inova facilities, patient choice and insurance requirements determined where those patients were transferred, not lack of bed space.”

Gilmore agreed that, when there are special physical needs in addition to psychiatric involvement, the cases are more complicated. “It isn’t just a matter of a bed,” he said, “it’s a matter of the right bed. That’s why we have to develop working relationships with other hospitals around the region — then they will know us and we will know their procedures as well,” he said.

CITY COUNCIL members Rob Krupicka and Paul Smedberg have been monitoring the closing of the psychiatric unit at Alexandria Hospital.

“I know there have been some concerns and we need to address those,” Smedberg said. “I am proposing that we re-constitute the Hospital Task Force that functioned several years ago. Inova Alexandria Hospital is our local hospital and we want to work closely with them not only on this issue but others that may arise as well.”

Currently, those who are involved in the lives of psychiatric patients who might need to be detained prior to commitment meet each month. “We are trying to get the September meeting moved up from the 30th to a date that is sooner,” Gilmore said.